Sometimes, it can seem like trainers and trainees are separate entities, inhabiting separate worlds, in two separate spheres of experience. However, trainees become trainers, and there is always a period where the trainer has only just stopped being the trainee. We therefore reached out to international educational leaders in ENT training to ask them to share what they would have said to their former trainee selves. We would love to hear from you on what you would say if you were to meet yourself coming back too, on social media via @ENT_AudsNews and www.facebook.com/EntAudiologyNews
NEW ZEALAND
Angela Butler, MBChB, FRACS, Training Chair, NZSOHNS; Otolaryngology Head and Neck Surgery, Christchurch Hospital, New Zealand.
What do you think your trainee self should have known on day one?
Not to be so overly critical of myself. During training, you are constantly under a microscope - or at least it feels that way. I think it is really easy to focus on all your weaknesses and shortcomings. Although it’s important to identify areas to improve on, don’t let this distract you from what your strengths are.
What do you wish you had done differently as a trainee, or during training in general?
In all honesty, I would not have changed any of my experiences. Even those that were more challenging. Those experiences brought me to where I am today. However, there is one thing I would have suggested to my younger self - therapy. I have recently started seeing a psychologist on a regular basis and it has really changed my perspective on my work and life in general. Perhaps it helps me to be less self-critical!
What do you hope for trainers and trainees in ENT today and in the future?
I could write a chapter in a book about this topic. If I were to pick one, I would hope for more trainees. In New Zealand we are heavily reliant on overseas trained ENT surgeons - they are an integral part of our health system (and we would love to see more come and join us!). I would, however, love to see us train more local ENT surgeons as well. We are limited by funding and by bureaucratic/management decisions, and this is incredibly frustrating with so many trainers wanting to teach.
JAPAN
Seiichi Yoshimoto, MD, Master of Education; Head & Neck Surgeon, Department of Head and Neck Surgery, The National Cancer Center Hospital, Tokyo, Japan.
What do you think your trainee self should have known on day one?
It may be discouraging to think about the long road to mastering all the techniques, but if you continue to make steady efforts, you will eventually learn them.
What do you wish you had done differently as a trainee, or during training in general?
I wish I had made more time for myself and my family. Studying medicine is important, but doing housework, reading books and gaining social knowledge are also necessary to be a good medical professional.
What do you hope for trainers and trainees in ENT today and in the future?
I hope for trainees and trainers to be truly equal. In Japanese society, it’s important how old we are and how many years we work. However, there should be no hierarchical relationship between them. Trainees are responsible for miscellaneous duties in exchange for instruction. Trainers also can refine their skills and knowledge through teaching.
USA
Sonya Malekzadeh, MD, FACS,Residency Program Director; Professor and Academic Vice Chair, Department of Otolaryngology-Head and Neck Surgery, MedStar Georgetown University Hospital, Georgetown University Medical Center, Washington, DC, USA.
What do you think your trainee self should have known on day one?
Residency is a time of intense learning as well as personal and professional growth. It’s also clouded with stress and fatigue, managing the day-to-day work of patient care while also striving to master all otolaryngology knowledge and skills in a short five years. I would urge my trainee self to slow down, embrace the process and enjoy the journey.
What do you wish you had done differently as a trainee, or during training in general?
I wish I had taken advantage of opportunities to network and form strong mentoring relationships with my attendings as well as the broader otolaryngology community. Mentorship is critical for career enhancement as well as psychosocial support. For women especially, sponsorship is equally, if not more, important to ensure that you are optimising your network. I encourage trainees to advocate for themselves and to seek a diverse portfolio of individuals to guide and support them through the next phases of life and career.
What do you hope for trainers and trainees in ENT today and in the future?
My hope is trainees and trainers will recognise the importance of wellbeing and take better care of their physical and mental health during the demanding training years and beyond. Medicine is a fast-paced profession in a high-stress environment, and it’s important to understand the warning signs of burnout and to prioritise self care to prevent it. The good news is that wellness is being prioritised and addressed at institutional and departmental levels with resources and initiatives to assist individuals in achieving balance in their personal and professional lives.
ARGENTINA
Prof Hector Ruiz,President, Pan-American Association ENT-HNS; Director, Dr Hector E Ruiz Throat-Nose and Ears Clinic, Rosario, Argentina.
What do you think your trainee self should have known on day one?
As an ENT student I received my father’s teaching based on knowledge and humanitarian treatment of the sufferer, the patient. The professors of the faculty gave their best without fear of failure, and looked for success, the deep study of the organism and knowledge to arrive at the logic of the disease and the psychology of the patient. I should have known that I would study all my life, that everything would revolve around the patient and the teaching of what was learned with the addition of the new and the discovery. Investigation is an obligation.
What do you wish you had done differently as a trainee, or during training in general?
The training was intense and consumed a lot of time, so I sacrificed experiences, readings and recreation. Today there are better methods for training and living at the same time through the internet, distance courses (Zoom) and practices in many centres with rotations in different national and foreign services to see the panorama from different points and the patient more organically and psychologically integrated.
What do you hope for trainers and trainees in ENT today and in the future?
Medicine and the world have changed a lot. Computing, internet, genetics, data banks and patients, prevention, images, vaccines, artificial intelligence and now robotics have raised it close to accuracy. I hope that, despite these tools, the trainers and trainees do not forget that the patient is a human being like us.
TAIWAN
Sheng-Po Hao MD, FACS, FICS,Professor & Chairman, Department of Otolaryngology Head and Neck Surgery, Shin Kong Wu Ho-Su Memorial Hospital, Taiwan; Professor of Otolaryngology, School of Medicine, Fu-Jen University, Taiwan; Secretary General & Founding President, Asian Society of Head & Neck Oncology (ASHNO); Chair, International Advisory Board, AAOHNSF.
What do you think your trainee self should have known on day one?
The resident training in otolaryngology will be a period of five years of ‘learning by doing’ in Taiwan. The trainee should know it will be a brand-new journey to start, a good opportunity to learn, to work with others, to be employed, to prove yourself though under supervision, and to continue and eventually establish your own career.
What do you wish you had done differently as a trainee, or during training in general?
I wish I could be more mature and realistic in working and dealing with colleagues in the department. I need to look into communication skills and ethics too. I should have spent more time with my family and keep a much more balanced life.
What do you hope for trainers and trainees in ENT today and in the future?
Mutual respect between trainers and trainees is very important. The trainees nowadays in Taiwan could consider and redefine ‘professionalism’. You can only build up your own credit by winning the trust from the patients you take care of, and the colleagues you work with, as you respect your profession.
UNITED KINGDOM
Lisha McClelland, FRCS, Consultant ENT Surgeon, Department of Otolaryngology, University Hospitals Birmingham, UK.
What do you think your trainee self should have known on ‘day one’?
How to say ‘no’. As trainees, we do as we are told and try to please everyone. As consultants, we will be asked to do lots of extra tasks. It is easy to get overwhelmed at the start. Ask yourself if you want to do it, if it’s in your best interest and if it will help your patients. Remember the person who’s asking you to do the task has a vested interest as they don’t want to do it themselves!
What do you wish you had done differently as a trainee, or during training in general?
We are well trained to be ENT surgeons when we qualify; it is usually other aspects of the job that we have little experience in managing. I wish I had learnt how to deal with complaints. They are not very frequent thankfully, but they take up a disproportionate amount of time and cause a lot of stress and anxiety. What have I learnt? Ask for guidance and support from senior colleagues, learn from the experience and put in any corrective measures to your practice. Then get on with the job and put it behind you. It is easy to focus on the negative and forget the huge amount of good you do.
What do you hope for trainers and trainees in ENT today and in the future?
I hope that trainees leave their training programme feeling fully equipped to start as a day one consultant and manage all aspect of the job. I hope that trainers continue to be an inspiration and role model for our trainees. Trainers are the best resource that a trainee has to prepare for their future life as a consultant.
